APPROACHING ALTERNATIVE CARE

THROUGH AN EMPATHIC LENS –

THE INCREDIBLE YEARS PROGRAMME

Isabel Silva, PhD & Maria Filomena Gaspar, PhD

Faculty of Psychology and Educational Sciences

University of Coimbra, Coimbra, Portugal

BASPCAN Congress, Edinburgh, Scotland April 13, 2015

It is wonderful to be here!

University of Coimbra

I. Silva, Edinburgh, April 13, 2015

Overview

• Background

• The Incredible Years Training Programme

• Implementation of the IY in RCC

• Outline some findings

• Comments and questions

Background

• Behaviour problems a growing issue in RCC; becoming more prevalent at younger ages (ISS, 2011, 2012)

• Residential Child Care Staff: Assumes parental, teaching, counseling and therapeutic functions (Anglin, 2002; Shealy, 1995; Moses 2000)

• Lack of: Care staff skills to manage behaviour problems; specific training in evidence-based child management skills; a clear, coherent, positive framework for delivering quality care practices (Martins, 2004; Pereira, 2009; Santos, Calheiros, Ramos & Gamito, 2011)

• Council of Europe, 2009: Recommends the promotion of quality care to improve children living in residential settings.

How to empower care staff skills in order to positively deal with resident children?

Training and Group Setting as a skill’s development context

Research question & challenge…

Behaviour problems through a new lens

A New Perspective…

• “Family” as metaphor in residential care (Anglin, 2002; Kendrick 2013)

• Research suggests that is possible to consider residential staff carers’ interventions in the light of current literature on parental childrearing and parent-child relationships (Bastiaanssen et al., 2012; Boone, 2012; Petrie et al., 2006)

• Parenting Training research points to positive results in improving parents skills and reducing behaviour problems in children (Kaminski et al., 2008; Taylor & Biglan, 1998; Webster-Stratton, 1998)

Why use Parenting Training resources?

Rationale for the study

One of the most effective and evidenced-based psychosocial intervention programmes, for both the treatment and prevention of conduct disorder in children (3-8 years old) (Webster-Stratton, 2011; Webster-Stratton & Reid, 2006; Webster-Stratton, Reid, & Hammond, 2004)

Successfully transported to the Portuguese context (Azevedo et al., 2013; Cabral et al., 2009/2010; Webster-Stratton, Gaspar, & Seabra-Santos, 2012)

Promising results with other caregivers (foster care, nursery care) reported increases in positive parenting and decreases in child conduct problems (Bywater et al., 2011; Bywater, Hutchings, Gridley, & Jones, 2011; Hutchings & Bywater, 2013; Linares, Montalto, Li, & Oza, 2006; McDaniel, Braiden, Onyekwelu, Murphy, & Regan, 2011; Nilsen, 2007)

IY offers: 1) Theoretical model (social learning theory; coercion process; modeling theory; relational and attachment theories); 2) Structured training in effective parenting practices; 3) Daily practice; 4) Tollkit to support the care staff teams in their role

The specific case of the Incredible Years Basic Parent Programme…

Teacher Programme

6 full day sessions held monthly

Child Dinosaur treatment Programme: 6 children, 18 - 22 weekly sessions

Child Dinosaur Classroom Programme:3 year curriculum, 2 sessions per week, 30 weeks

ADVANCED Programme: 9 sessions helping adults communicate & problem solve

The Incredible Years Programmes

School Aged BASIC Parent Programme: 10 - 12 sessions, 6 - 12 years

Pre-School BASIC Parent Programme: 14-18 weekly sessions, 3 – 6 years

School ReadinessProgramme:4 pre-school sessions 2 – 4 years

Infant (eight sessions) 0 - 12 months toddler 1 - 3 year olds (13 sessions) programmes

• Translation and adaptation of materials• Leader training and supervision• Research

Basic Parenting Programme- with a community sample- with a clinical sample- with socioeconomically-disadvantaged families- with staff carers in the context of residential child care Teacher Classroom Management Programme (TCM)

Basic Parenting Programme plus TCM- research trial in Portugal that aimed to study the efficacy of the Incredible Years Basic Parent programme plus TCM in the reduction of early disruptive behaviour in preschoolers

Development of the IY programmes in Portugal…

Participants Children Ages

Context Duration Design

2 Intervention Groups (n = 27)

Children (n = 12)

2 Non- Intervention

Groups (n = 20)Children (n = 13)

3-8 Residential Child Care Centers (RCC)

13 sessions (1 weekly

session = 2 hours; 2 IY

trained facilitators)

Exploratory Study

Non-Randomized

Assessment: Moment 1 (baseline); Moment 2 (after intervention; 6 months after M1); Moment 3 (12 months after M1).

Implementation of the IY in RCC: Method

I. Silva, Coimbra, January 7, 2014

Group Sessions:• 13 weeks (2-hour sessions) of training with the IY (Webster-Stratton,

2000)• Led by two trained professionals in IY• Run in the residential centre, on the day and time best suited for the

group• Make-up sessions

Method & Process:• Focus on cognitive, behaviour & affect, collaborative approach and

skill development through: Group discussion, Video Modeling, Role plays & practice/rehearsal, Weekly assignments; Reading materials; Weekly evaluations

Training Targets:• Play; Involvement; Descriptive Comments• Praise; Rewards• Effective Limit Setting; Clear Commands; Household Rules• Handling misbehaviour; Ignoring; Time-Out; Consequences;

Problem SolvingBottom - use liberally; Top - use selectively

Intervention

MeasuresCare Staff: Childrearing

Practices, Sense of Parental Competence and Depressive

Symptoms

• Adult‐Adolescent Parenting Inventory: Form A & Form B (AAPI – 2; Bavolek & Keene, 2001)

• Parental Sense of Competence Scale (PSOC; Johnston & Mash, 1989)

• Beck Depression Inventory (BDI; Beck et al., 1961)

Carer-Child Interaction• Dyadic Parent-Child Interaction Coding System

(DPICS; Robinson & Eyberg, 1981) | Evaluates a range of carer and child behaviours, while playing with fixed set of toys. The situation was recorded for 25 minutes at pre-post moments.

Children: Behaviour Problems Reported by Care

Staff

• Strengths and Difficulties Questionnaire (SDQ; Goodman, 1997)

Satisfaction with the IY Programme

• Weekly Evaluation (content, DVD’s, group leaders, group discussion)

• Final Satisfaction Questionnaire programme overall (teaching format, usefulness of specific educational techniques, group leader(s), group support) (http://incredibleyears.com/for-researchers/measures/)

Some data… Carer - Child

InteractionIntervention

IC1 (N=15) IC2 (N=12)

Pre

M±SD

Post

M±SD

Test

(Z)a

Sig

(p)

Pre

M±SD

Post

M±SD

Test

(Z)a

Sig

(p)

CARER

Positive parenting 23.53±13.17 42.60±15.08 -2.95 .003 18.83±9.09 53.42±31.59 -3.06 .002

Negative commands 6.13±3.85 2.73±2.34 -2.39 .017 3.33±4.03 0.75±1.14 -2.20 .027

Total commands 97.87±40.97 68.53±27.68 -2.61 .009 76.42±34.05 42.17±22.39 -2.98 .003

Critical statements 18.00±10.34 10.13±7.68 -2.45 .014 14.25±13.94 5.50±6.10 -2.14 .033

Total critical 24.13±12.80 12.87±9.20 -2.64 .008 17.58±16.22 6.25±6.51 -2.59 .010

CHILD

Negative behaviours 11.27±7.81 5.67±5.08 -2.32 .020 21.55±37.72 5.42±6.83 -2.54 .011

Note: a. Non-Parametric Test: Wilcoxon; Children (3-8 years): (IC1 Pre n=6; IC1 Post n=6); (IC2 Pre n=6; IC2 Post n=5)

• These preliminary observations suggest gains in the quality of the interactions between staff carers and resident children, in short term, after the delivered of an evidence-based program, like the IYP. Nevertheless, future studies must be undertaken (small sample).

• As residential care workers we want to enhance children’s empathy, safety, welfare and well-being.

To sum it up…

Some words of the care workers…• “I was amazed when at dinner time one of the children turned to

another and said: “Good job, you are eating all the fish! Very good!” (Modelling Principle)

• “The Reward Programme it’s working! The children can tighten their seat belts alone when we get into the van!” (Principle of rewarding the daily success)

• “I have learned to apply new strategies, new ways to deal with the children’s behaviour. The group training allows us to achieve some consensus in the way we all deal with the children.”

• “For me it was important to improve the relationship with the children as a result of the improvement of my behaviour. Now, I think with a “cold head”: I’m an adult, I have to stay calm.”

Webster-Stratton, C. (2010). Os Anos Incríveis: Guia de resolução de problemas para pais de crianças dos 2

aos 8 anos de idade (M. I, Donnas Botto, Transl; M. F. Gaspar & M. J. Seabra-Santos, Revisão Científica).

Braga: Psiquilíbrios Edições (Original publicado em 2005).

Silva, I. S., Gaspar, M. F., & Anglin, J. P. (2014). Webster-Stratton Incredible Years Basic Parent Programme

(IY) in child care placements: Residential staff carers’ satisfaction results. Child and Family Social Work, 1-11.

doi:10.1111/cfs.12129

Silva, I. S., & Gaspar, M. F. (2014). Supporting Portuguese Residential Child Care Staff: An Exploratory Study

with the Incredible Years Basic Parent Programme. Psychosocial Intervention, 23(1), 33-41. doi:

10.5093/in2014a4

Silva, I. S. & Gaspar, M. F. (2014). The challenge of improving positive residential care practices: Evidence

from staff experiences in Portugal. International Journal of Child and Family Welfare, 15(1/2), 92-109.

REFERENCES

THANKS FOR YOUR ATTENTION!

COMMENTS & QUESTIONS

For more information, feel free to email:Isabel Silva | isabel.s.silva@sapo.pt

Maria Filomena Gaspar | ninigaspar@fpce.uc.pt

https://www.facebook.com/anosincriveis.Portugal http://incredibleyears.com